Mykietiuk A, Carratalà J, Domínguez A, Manzur A, Fernández-Sabé N, Dorca J, Tubau F, Manresa F, Gudiol F
Infectious Disease Service, Institut d'Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, University of Barcelona, Feixa Llarga s/n, L'Hospitalet, 08907, Barcelona, Spain.
Eur J Clin Microbiol Infect Dis. 2006 Jul;25(7):457-62. doi: 10.1007/s10096-006-0161-8.
The aim of this study was to evaluate the effect of prior pneumococcal vaccination on the clinical outcome of 554 consecutive hospitalized adults with community-acquired pneumococcal pneumonia from 1995 to 2004, 61 of whom had been vaccinated in the 5 years before admission. Outcome variables that were compared in vaccinated and unvaccinated adults included the occurrence of bacteremia, the time to resolution of pneumonia symptoms, the length of hospital stay, and mortality. Prior pneumococcal vaccination was associated with a lower risk of bacteremia (odds ratio 0.46, 95% CI 0.22-0.98). Compared with unvaccinated patients, vaccine recipients had better clinical outcomes, which included a faster resolution of pneumonia symptoms. The median length of hospital stay was shorter in vaccinated patients (8.0 vs. 9.0 days; p=0.032). Overall case-fatality rates did not differ significantly between groups (1.6% vs. 6.2%; p=0.233). In conclusion, prior pneumococcal vaccination appears to be associated with a lower risk of bacteremia, a faster time to resolution of symptoms, and a shorter hospital stay in adults with pneumococcal pneumonia. The findings presented here provide additional support to the current vaccine recommendations and should encourage healthcare providers to increase pneumococcal vaccine coverage among targeted adult populations.
本研究的目的是评估1995年至2004年期间连续住院的554例社区获得性肺炎球菌肺炎成年患者中，先前接种肺炎球菌疫苗对临床结局的影响，其中61例在入院前5年内接种过疫苗。对接种疫苗和未接种疫苗的成年人进行比较的结局变量包括菌血症的发生、肺炎症状缓解的时间、住院时间和死亡率。先前接种肺炎球菌疫苗与较低的菌血症风险相关（比值比0.46，95%可信区间0.22-0.98）。与未接种疫苗的患者相比，接种疫苗的患者临床结局更好，包括肺炎症状缓解更快。接种疫苗患者的住院中位时间较短（8.0天对9.0天；p=0.032）。两组的总体病死率无显著差异（1.6%对6.2%；p=0.233）。总之，先前接种肺炎球菌疫苗似乎与肺炎球菌肺炎成年患者较低的菌血症风险、更快的症状缓解时间和更短的住院时间相关。此处呈现的研究结果为当前的疫苗推荐提供了额外支持，并应鼓励医疗保健提供者提高目标成年人群中肺炎球菌疫苗的接种覆盖率。
